Hormonal preparations for ovarian stimulation. How to stimulate ovulation with Gonal? Clinical manifestations of OHSS during ovulation stimulation

(if such a diagnosis is indeed established) resort to medical methods. In particular, to taking oral medications. For example, if a woman does not ovulate, then she is prescribed drugs that stimulate these processes. Experts divide them into three groups, since the tablets of each group have inherently different actions. For example, drugs of the first group stimulate the growth and formation of follicles on the ovaries. The drugs of the second group are called ovulation triggers, which stimulate (or imitate) the release of luteinizing hormone, which ensures the maturation of the egg and, in fact, ovulation itself. And drugs related to the third contribute to supporting the functioning of the corpus luteum.

Keep in mind that a competent doctor, in the case of prescribing pills that stimulate ovulation, will prescribe an examination for patency of the fallopian tubes. This is necessary in order to exclude .

Clomiphene

Treatment with this drug is prescribed for women with irregular ovulation or if it is completely absent. Patients diagnosed with polycystic ovaries are also prescribed clomiphene. In some cases, when the reasons for the prolonged non-occurrence of pregnancy are not established, this drug is also prescribed.

Clomiphene is a tablet drug, the action of which is based on an increase in the level of hormones that stimulate the ovaries and also promote the release of the egg. Under the influence of clofimen, the pituitary gland produces more of the necessary hormones, preparing several mature eggs at once.

A single treatment with clomiphene is approximately 5 days. There may be several cycles of treatment before pregnancy occurs, but as a rule, 1-2 cycles are enough to start regular ovulation. In particularly difficult situations, a course of 12 cycles is needed to restore ovulation. In some cases, a woman is prescribed an additional dose of the drug metformin, which, together with clomiphene, increases the likelihood of ovulation and pregnancy.

As a rule, after treatment with clomiphene, 70% of women ovulate, and 15% -50% have a long-awaited pregnancy. By the way, in 7% of women while taking this drug, twins are born.

In order to stimulate the growth of follicles, the following drugs are also prescribed: clostilbegit, puregon, menogon.

Clostilbegit

Clostilbegit, like the drug described above, stimulates the production of pituitary hormones to improve the growth of follicles and to stimulate ovulation. In addition, these pills help produce the hormone prolactin, which determines the presence and amount of milk in the mammary glands.

Clostilbegit is taken once a day, 1 piece from the 5th to the 9th day after the onset of menstruation.

But, keep in mind that this drug, unlike the previous one, should not be taken often. Moreover, and any doctor will tell you, the use of clostilbegit is possible only 5-6 times during a lifetime. The fact is that the substances contained in these tablets provoke severe depletion of the ovaries. And this, in turn, means that the eggs, the number of which each woman has is limited and determined from the moment of birth, will simply be used up. And then the pregnancy will definitely not come. After all, nature has laid down that the eggs mature one by one, maximum two, per month. In the case of ovulation stimulation, the number of maturing eggs at a time increases significantly.

When taking clostilbegit, it is important to monitor the endometrium, as this medicine has a bad effect on its growth. And it may be that conception will occur, but the pregnancy will not continue due to the thin endometrium.

Puregon

The next drug, Puregon, has the same effect. It also activates the pituitary gland, stimulates the growth of follicles and makes ovulation possible. Puregon is used both in the case of natural conception and in the case.

Menogon

Menogon also stimulates the production of the hormones FSH and LH and increases the concentration of female hormones - estrogens. This drug stimulates the growth of follicles on the ovaries. Menogon, unlike clostilbegit, builds up the endometrium.

Menogon is taken on the second day of menstruation. As a rule, the course of treatment is 10 days. However, the required number of doses in each individual case should be determined by the doctor. He monitors the reaction of the ovaries with the help of ultrasound and, based on its results, makes an appointment.

As a rule, after taking pills that stimulate ovulation, other medicines are prescribed. This time, a course of injections with hormonal preparations containing human chorionic gonadotropin is carried out. This hormone is found in drugs such as pregnil, profazi, horagon, gonacor and others.

In fact, there are other pills that stimulate ovulation, but we have named the main ones that are used most often. Women who have problems with ovulation should take note that an ultrasound should be done before stimulation, which will allow monitoring the maturation of the follicle. During the treatment, the frequency of this procedure will be 2-3 times. Thus, the doctor will be able to count the number of growing follicles, measure their diameter, and also determine the thickness of the uterine mucosa.

For every woman who dreams of becoming pregnant, drugs are selected, taking into account the results of tests and ultrasound examinations. As statistics show, the likelihood of pregnancy depends on many factors. Important among them are the duration of infertility, its causes, the age of the woman.

Specially for Olga Rizak

Increasingly, women are turning to the gynecologist with problems with conception. But medicine does not stand still, it is constantly developing, so the desired pregnancy can occur after treatment with special drugs that stimulate ovulation.

Most often, the inability to become pregnant is associated with the absence of ovulation as such or with its irregular course. There may be several reasons for this:

1. Diseases of the pelvic organs of an infectious and inflammatory nature (salpingoophoritis, ovaries, etc.).
2. Too little weight of a woman, usually less than 48 kg, at which there is an insufficient production of sex hormones, which leads to a lack of ovulation and amenorrhea.
3. Hormonal changes in the body due to stress, overweight (when the body mass index is more than 25), with certain thyroid diseases (hypo- or hyperthyroidism), etc.
4. Long-term use of oral contraceptives. In this case, the body ceases to produce hormones on its own, and it sometimes takes several months to fully restore this ability.
5. Excessive physical activity can also negatively affect ovulation, especially if it is associated with the use of synthetic sports nutrition supplements. These drugs have a very negative effect on the female reproductive system.

In what cases is stimulation needed and when it is not carried out

It is possible when a couple cannot conceive a child for a year. If the woman's age is 35+, then this period can be reduced to six months. In any case, a thorough diagnosis is necessary (preferably both partners) to identify the true causes of infertility and make a decision on stimulation.
In particular, the following diagnostic studies are carried out:

1. Collecting a patient's medical history, which takes into account her age, the presence / absence of abortions and pregnancies, miscarriages, chronic diseases, wearing an intrauterine device, etc.
2. The patency of the fallopian tubes is checked. For this, non-operative and operational methods are used. The first include metrosalpingography (X-ray examination). A variation is ultrasonic metrosalpingography, when the patency of the tubes is examined with the help of a contrast agent and ultrasound equipment. These methods are not universal, they have their drawbacks, such as the harmfulness of radiation and possible errors in the result. For a more accurate diagnosis, an operational study is used, but giving the most reliable results.
3. The usual ultrasound examination, which can show possible inflammatory, polycystic, various neoplasms and other pathologies of the female reproductive system.
4. In some cases, ovulatory failures can occur due to hormonal disorders, so donating blood to determine the amount of female sex hormones is a prerequisite. At the same time, it is recommended to conduct studies of the activity of the thyroid gland, since this organ has a direct impact on female fertility.
5. The spermogram of the partner should also be carried out, since sometimes the reason for the lack of pregnancy may be insufficient mobility and viability of spermatozoa.
6. Partner compatibility test. If the results are unfavorable, the doctor may suggest artificial insemination.

It should be noted that contraindications to stimulation are inflammatory diseases of the uterus and (or) ovaries, tubes, adjacent organs and systems (urinary, gastrointestinal tract), hormonal fluctuations, the onset of menopause or the preclimatic period.

After diagnostic measures and in the absence of absolute contraindications, the gynecologist decides on the appointment of drugs that stimulate ovulation.

Ovulation Stimulation Methods

Stimulation of ovulation is possible with the help of drug therapy (pharmaceutical preparations), as well as using folk recipes and non-traditional methods of treatment.

Pharmaceutical preparations to stimulate ovulation

Vitamins and trace elements

Stimulation of ovulation is impossible without taking vitamin complexes and beneficial trace elements. True “female” vitamins include E, A, B (folic acid is required), C. Vitamin D is also recommended, especially for women living in areas where sunny days are rare.

Stimulation of follicle maturation with vitamin E

Vitamin A helps follicles and regulates the amount of cervical fluid.
B vitamins are recommended to be taken both at the stage of pregnancy planning and during it, as they not only prolong the luteal phase of the cycle, promote endometrial growth and egg maturation, but also eliminate toxicosis during pregnancy, prevent miscarriages and help healthy development of the fetus.
Vitamin E stimulates maturation, “supports” ovulation itself and increases the production of progesterone, which is especially useful for deficiency of this hormone.
Vitamin C contributes to the normalization of hormonal levels, and also serves as a means of preventing the development of DNA abnormalities in the unborn fetus.
Also, when preparing for pregnancy, it is advisable to monitor the sufficient intake of Omega-3 polyunsaturated fatty acids in the body. They are found in highest concentrations in fatty fish, synthetic fish oils, and linseed and olive oils.
The means to stimulate ovulation also include preparations containing selenium, zinc and iron.

Specialized pills that stimulate ovulation.

Clostilbegit is a drug designed to enhance the maturation of follicles. This effect can cause multiple pregnancy. An interesting fact is that the pharmacological action of the drug has not been fully studied, since it was originally developed as a contraceptive. But the effect turned out to be the opposite, so Clostilbegit is currently successfully used to treat infertility, with both partners.
The drug may not be taken independently, but with auxiliary means. The classic pattern is:

• 5-9 days of the cycle, 1 tablet of Clostilbegit per day (provided that only one remedy is taken);
• if Puregon is prescribed in parallel, then Klostilbegit begins to be taken from the 3rd day of the cycle and ends on the 7th. From the 8th day of the cycle, they begin to drink Puregon. In this case, constant monitoring by ultrasound is necessary. As soon as the follicle reaches 18 mm in diameter, these drugs are canceled and Pregnyl is prescribed, which supports the maturation of the eggs. After that, there comes a favorable time for conception.

Ovarian stimulation drugs can be taken no more than 5 times in a lifetime to avoid atrophy of the reproductive system.

Gonal-F is a drug produced in the form of a powder for injection and used in the planning of IVF (in vitro fertilization), as well as in case of ineffectiveness of other methods of treatment. The drug is administered subcutaneously, the dosage is determined by the doctor individually. Of the pluses, one can single out its effectiveness, of the minuses - the high cost and complexity of application.

Stimulation of ovulation with folk remedies

Simultaneously with drug therapy or as an independent treatment, traditional medicine methods can be used. The most common of these is phytotherapy (herbal treatment).

1. Sage - used when the lack of ovulation is associated with a lack of estrogen.
2. Upland uterus - used for lack of progesterone. Prevents miscarriages.
3. Red brush - can be used simultaneously with sage or hogweed.
4. Plantain, rose petals, and aloe are also widely used.

The advantages of herbal medicine are relative safety and low cost, the disadvantages are the duration of treatment. It should be remembered that phytotherapy is still a treatment, and herbs are medicines, so a doctor's consultation is required.
Read more about ovulation stimulation with folk methods.

Alternative therapy

1. Therapeutic mud also stimulates ovulation, they are recommended in cases where there are diseases of the nature. Therapeutic muds relieve inflammation (they are especially effective in chronic diseases), restore impaired reproductive functions.

You can buy such a remedy at a pharmacy, it only needs to be warmed up a little and applied to the stomach at the level of the ovaries. If possible, you can go to a sanatorium specializing in mud therapy, or a suitable resort (for example, Saki).

1. Stimulation of ovulation with acupuncture is a rather controversial area of ​​medicine, however, there are many cases where the impact on acupuncture points had a positive effect in the treatment of infertility. The difficulty of this method lies in the fact that it will take a lot of time to find a professional who specializes in the treatment of female infertility with acupuncture.

All of these methods of restoring ovulatory function are effective. However, they cannot be used randomly. A doctor's consultation is necessary, as well as an extensive and comprehensive diagnosis of both partners.

The happiness of every woman is known in motherhood, but it is not always so easy. Many women are not able to get pregnant for many reasons, so they are forced to seek help from specialists. To date, there are a huge number of clinics in which doctors are ready to help women find out what real motherhood is.

One of the modern effective ways to accelerate fertilization is ovarian stimulation for pregnancy planning. It is performed by taking hormonal drugs, strictly selected for each specific case. Very often, this method of increasing the chances of conception is used for artificial insemination or in vitro fertilization, but with similar success it can be used in the absence of ovulation due to age or hormonal failure in a woman. In any case, the procedure has a positive effect.

Possible problems

The natural process of egg formation is its full formation, after which the follicle enters the fallopian tube and bursts, releasing the egg. Violation of this process leads to the formation of problems with conception.

The reasons may be:

• serious gynecological diseases;
• hormonal disruptions;
• excess weight;
• infectious diseases and much more.

Most often, ovulation is absent due to hormonal disruptions in the body of a woman.

Operating principle

Stimulation of the ovaries for planning conception is carried out by taking hormonal drugs to normalize the natural menstrual cycle, during which it will be possible to fertilize a mature egg. It can be done naturally or artificially.

Almost half of the cases of using this method of stimulation has a successful ending, but this method is suitable only for women whose reproductive organs are absolutely healthy, and problems appear due to malfunctions in the hormonal system of the body. But even in this case, many do not dare to use this method, since taking hormonal drugs has a number of side effects that may occur. Among the negative consequences of ovarian stimulation for pregnancy planning (reviews from real patients confirm this), pain in the ovaries can be called. The procedure can also lead to the depletion of the egg reserve, which has certain consequences that affect the general condition of the woman's body.

Dosing regimen

Only a qualified doctor is able to prescribe the medicines necessary for each specific case, since even for this he needs to familiarize himself with a number of results of examinations and analyzes of a woman. The dosage of drugs is also selected individually, all treatment processes are combined only in that they begin their effect on the body only after the third or fifth day from the start of the menstrual cycle.

Most often, ovarian stimulation for pregnancy planning is carried out by intramuscular injection of the drug. This choice is explained by the rapid effect of gonadotropic drugs on the body, but other methods can be used to speed up conception:

• pills;
• antiestrogen substances;
• recombinant drugs.

To evaluate the effectiveness of the chosen method, the entire process of egg maturation is strictly controlled by specialists with the help of regular ultrasound examinations. As soon as the egg fully matures and the follicle bursts, the woman is given an injection of human chorionic gonadotropin, which contributes to the further favorable course of pregnancy. In the case of natural fertilization, conception occurs immediately after this. If it is planned to carry out in vitro fertilization, then the next day it is necessary to take the egg.

Other options

Stimulation of the ovaries for planning conception by the described method is the most commonly used by doctors, but there are also cases when it does not have the desired effect on the body. In such cases, women increase the dose of prescribed drugs or recommend other medications. In any case, the scheme will be identical:

• stachala taken gonadotropins;
• after them - follicle-stimulating hormone in recombinant form;
• the third step is antiestrogen drugs;
• the final one is chorionic gonadotropin.

Each of the stages has multiple options for possible prescribed drugs. In the absence of results after applying each, it will be necessary to retake tests and undergo examinations for a more accurate selection of the next set of measures. At the same time, you should know that conception very rarely occurs immediately in the first month of taking medications, usually you have to carry out 2-3 courses of treatment until a positive result is obtained.

Most popular option

Most often, ovarian stimulation is carried out for pregnancy planning with Clostilbegyt. The active substance of the drug acts directly on the ovaries, provoking the accelerated development and maturation of follicles in them. Stimulation is carried out by the action of the drug on the hypothalamus and pituitary gland to produce the hormones needed by the body. Means "Klostilbegit" is produced in the form of tablets, has analogues. The course of taking the drug is prescribed by a doctor and lasts no more than five days. Usually the start of the reception coincides with the second day of the cycle, but the exact date depends on the level of hormones in the patient's body and the characteristics of her natural cycle. That is why you should not use such drugs on your own, because improper use of hormones can lead to negative consequences for the whole body. For the same reasons (due to the individuality of each organism), ovarian stimulation for pregnancy planning by folk remedies is not carried out.

After taking the drug and the start of the cycle, you should wait for the expected date of ovulation and a day before it, inject hCG to stimulate the mature follicle to burst and release the egg.

The final stage is the intake of medications that contribute to the retention of the fetus in the body in the event of pregnancy. Among these, such funds as "Dufaston", "Kraynon" and "Utrozhestan" are distinguished. They are recommended to be used from about the sixteenth day after the start of the cycle. Other estrogenic drugs may also be included in the scheme, on the recommendation of a doctor. In the absence of a positive result of using this method, a woman should re-take tests and switch to taking gonadotropins that mimic the natural processes of the female body.

Implementation of treatment

Any schematic stimulation of the ovaries should be carried out only after a thorough examination of the female body and identifying the cause of problems with conception. The fact is that some diseases can adversely affect the intake of hormonal medications and not only not give the desired result, but also worsen the general state of health.

Therefore, before starting stimulation, the following tests should be passed:

• for the presence of HIV and other sexually transmitted diseases;
• for TORCH infection;
• all tests to draw up a picture of the hormonal state of a woman's body;
• cytology test;
• analysis of the microflora of the vagina.

In addition, it is necessary to undergo a number of examinations, including an electrocardiogram, an ultrasound examination of the mammary glands and a test for the patency of the fallopian tubes. All this applies to mandatory procedures, but in some situations, ovarian stimulation for pregnancy planning may require additional research (hysteroscopy or laparoscopy).

In addition to all the above tests for a woman, the partner also needs to undergo an examination. This is necessary to confirm the activity of spermatozoa and exclude male infertility. Only after a thorough study of all the results obtained, the specialist prescribes an individual program to stimulate the work of the female reproductive system.

Prohibitions for use

Stimulation of the ovaries for pregnancy planning is not allowed for everyone, which is why such a thorough examination is necessary before its implementation.

It is strictly forbidden to use this method to conceive a child for women with:

• somatic deviations;
• obstruction of the fallopian tubes;
• hereditary diseases;
• genetic disorders;
• diseases of the kidneys and liver;
• diseases of the cardiovascular system.

In addition, the prohibitions apply to other, less significant violations in the body. If they are present, conception, the process of stimulation itself and further pregnancy can fail. Such disorders include any inflammatory diseases of the reproductive system, including sexually transmitted infections. With obstruction of only one tube, any cystic formations, including polycystosis, ovarian stimulation (reviews of experts confirm) is contraindicated. To obtain a positive result, you must first solve the problem with these diseases, and then proceed to stimulation.

Side effects

In addition to a number of contraindications, there are a number of negative consequences of ovarian stimulation for pregnancy planning. Since taking hormonal drugs affects the entire body as a whole, this often provokes hyperstimulation of the reproductive function. The reason for this effect may be an incorrectly selected dose of the drug or too violent reaction of the body to a certain substance. In any case, this once again confirms the need to take medications only on the recommendation and under the supervision of a doctor.

Besides:

• ovaries after stimulation very often hurt;
• a woman has problems with defecation;
• general health worsens;
• fluid accumulates in the body, which leads to swelling;
• many neoplasms in the form of cysts are possible.

The last consequences of ovarian stimulation relate to the procedure during the presence of polycystic disease in the body. In such cases, further surgical intervention may be required. However, in some cases, cysts can resolve on their own. In some cases, the consequences of hormonal stimulation can be an ectopic pregnancy.

Twins - happiness or a side effect?

Very often, in one cycle, several eggs mature in a woman at once, but with natural fertilization, only one of them remains. In the case of stimulation of pregnancy with hormonal drugs, both eggs do not have an advantage over each other and provoke a multiple pregnancy.

Age changes

Since every woman has a certain reproductive age, at the end of which it becomes impossible to conceive a child, after forty years the issue of pregnancy becomes very acute. For women at this age, the likelihood of getting side effects becomes higher, as well as the likelihood of multiple pregnancies. At the same time, stimulation is an effective method for conception at this age, and this chance should not be neglected.

Especially often this procedure is recommended for older women who decide on artificial insemination. An extracorporeal procedure is necessary for ladies after forty years, since she does not have her own viable eggs and she needs to turn to donors, especially if her partner has a sufficiently high-quality seminal fluid. The side effect in this case in the form of pain soon disappears.

Stimulation of the ovaries (patient reviews indicate this) after the age of forty gives positive results with timely access to a qualified specialist in this matter. The main thing is not to delay the implementation of the decision, because with each cycle there are fewer and fewer eggs.

Conclusion

In any case, before carrying out the procedure, in addition to passing the listed tests, you should make sure that there is no allergic reaction to any of the substances used in the method. Such a step will eliminate many negative consequences. It is also necessary to pass the required examination in advance.

Every year, this procedure helps many women to have a full-fledged family, give birth to long-awaited children and realize themselves as real mothers. Today, difficulty conceiving is no longer a major problem for most women at any age.

But be that as it may, this process must be taken very seriously. After all, not only successful fertilization, but also the health of the expectant mother depends on the right clinic and doctor.

In order for sexual intercourse to give rise to a new life, the sperm must meet with the egg. Its maturation is a complex multi-stage process that ends with ovulation - the exit from the ovary into the cavity of the fallopian tube. In a healthy female body, this happens monthly. Each new cycle is a new egg. But there are a number of complications in which ovulation does not occur. In this case, Gonal stimulation comes to the rescue.

A woman may not even be aware of this dysfunction - regular periods, well-being is normal. Doubts begin to creep in only after several unsuccessful attempts to get pregnant. Therefore, every couple planning a replenishment in the family should remember: if during the year unprotected sex did not give the desired results, this is a reason to seek the help of specialists. If it turns out that the reason is the absence of an egg, this is not a reason to talk about childlessness - ovulation can be stimulated with hormonal drugs (for example, Gonalom-F).

To prescribe stimulation with Gonal, you need a good reason. The schedule that a woman keeps, trying to determine the very time X, is not one. A blood test for hormones, carried out once, also cannot be considered a reliable source of information - there are many factors that cause short-term interference in the hormonal background.

A great way to figure out what's what is an ultrasound examination of the ovaries. But a woman should understand that no doctor can determine the reason for the lack of ovulation by one ultrasound. For one monthly cycle, it will be necessary to go through several studies in order to track the development of the follicle and see at which stage the failure occurs. Such observations should be carried out not for one month, but for at least two or three cycles in a row, and only after that a hormonal drug should be prescribed.

Examinations before stimulation

1. Check (most often by laparoscopy). If obstruction is detected, it is pointless to stimulate ovulation.
2. Determination of the level and luteinizing hormones, prolactin, androgens (male hormones), thyroid hormones - surrender at the beginning of the cycle.
3. Ultrasound research. With a standard cycle of 28 days, the first ultrasound is prescribed a week after the end of the last menstruation, then every 2-3 days until it is established at what stage egg maturation is stopped.

According to the results of observation, the reasons for the lack of ovulation can be as follows:

• Option 1 - the ovaries do not function at all, the follicles (capsules in which the eggs grow) do not even begin to develop;
• Option 2 - follicles develop, one of them becomes dominant, but at some point it stops growing and regresses (in this case, a blood test will show a lack of progesterone);
• Option 3 - the dominant follicle does not grow to the desired size and is luteinized, while forming a corpus luteum (in this case, a woman may not be aware of the absence of ovulation for a long time, since monthly bleeding is constant and cyclic, the level of progesterone is normal);
• Option 4 - the egg develops normally and grows to the required size, but cannot leave the ovary (the follicle does not break). Then it either regresses or develops into a cyst.

Stimulation of ovulation with Gonal or another hormonal drug prescribed by a doctor makes sense only in the first three cases. If the problem occurs at the last stage, when the cell has already matured, it may be enough just to give an injection of hCG (chorionic gonadropin) in time to help the follicle rupture.

Note! Before starting to stimulate ovulation in a woman, the future dad will also have to undergo an examination. The spermogram will determine if the sperm is suitable for conception and if the couple's biological materials are compatible.

How does Gonal-F work?

Gonal-F is one of the most powerful hormonal stimulants you can find in the pharmacy chain. That is why pharmacists release it strictly by prescription - indications for use are limited to a very narrow range of pathologies:

• defective or absent ovulation;
• multiple ovarian cysts ();
• a decrease in the activity of the hypothalamic-pituitary system, which causes a deficiency of sex hormones;
• scanty menstrual bleeding or their absence at a young age.

Gonal-F, as a potent drug, is used to stimulate ovulation when planning in vitro fertilization, when it is necessary to “squeeze” as many viable eggs from the ovaries as possible at a time. It promotes the growth of not one, but several dominant follicles at once, which subsequently increases the chances of a couple to become pregnant several times over.

The task of the drug is to compensate for the lack of follicle-stimulating hormone (hereinafter FG). In a healthy body, the brain, or rather the anterior zone of the pituitary gland, is responsible for the production of FG. By releasing follicle-stimulating hormone into the blood, the brain instructs the reproductive system to start the mechanism of egg growth, while producing two other hormones - progesterone and estrogen. Obviously, the lack of FG is immediately reflected in their number. Carefully weighed by nature itself, the hormonal system of a woman is out of balance and begins to throw unpleasant surprises, one of them is anovulation.

But, fortunately, genetic engineering does not stand still, and today hormonal compounds can be obtained by artificial synthesis. The main active ingredient of Gonal is a recombinant (produced with the help of geneticists) pituitary follicle-stimulating hormone (follitropin alfa). This is a drug of a very high degree of purification, therefore it acts on the female body in the same way as “its own” hormone.

Correct application of Gonal is capable of:

1. stimulate the growth of follicles in the ovaries;
2. establish a regular ovulatory cycle;
3. provoke the growth and differentiation of the endometrium so that an already fertilized egg can securely attach to the wall of the uterus;
4. get rid of menstrual disorders caused by hormonal deficiency;
5. increase the amount of "female" hormones (progesterone and estrogen).

The end result of therapy is the restoration of hormonal balance and, as a result, the ability of the ovaries to produce eggs. If the attending physician spared no time and effort for a long preliminary examination, correctly identified the cause of the problem and selected the correct dose of the drug, then the woman has every chance of becoming pregnant after the first course of treatment.

Stimulation by the gonal in the natural cycle

Gonal-F is available in two forms - in the form of powder ampoules, which must be diluted with saline before injection, and in the form of special syringe pens, which contain a ready-made solution of the required concentration.

Ampoules are presented in dosages of 75 IU (5.5 mcg) and 150 IU (11 mcg). The amount of solution that needs to be administered at a time depends on the daily dose of follitropin prescribed by the doctor and the amount of saline used to dilute the powder. All these figures must be indicated by the doctor.

A syringe pen in this sense is much more convenient - it has a scale and a dispenser that measures the desired dose. Taking into account the individual hormone needs of each woman, the pen is also available in several dosages:

• 300 IU (which equals 22 mcg or 0.5 ml);
• 450 IU (33 mcg or 0.75 ml);
• 900 IU (66 mcg or 1.5 ml).

The drug is injected subcutaneously and the procedure is absolutely painless. A woman can even inject the right dose of Gonal with a syringe pen on her own. Here is what is needed for this:

1. thoroughly wash and treat hands with an antiseptic;
2. remove the cap from the syringe pen, set the desired dose, attach the needle;
3. disinfect the injection site;
4. pierce the skin with a needle at a right angle (the needles in the syringe pen kit are very short and thin - the injection is practically not felt);
5. press the start button and enter the solution;
6. carefully remove the needle and apply a sterile cotton swab to the puncture site.

Dosage of the drug on different days of the cycle

As already mentioned, the dosage of Gonal is determined by the doctor. The standard stimulation scheme looks something like this:

1. the first week of the menstrual cycle - a daily dose of 75 to 150 IU;
2. the second week - the same dose;
3. the third week - with natural ovulation, the level of FG during this period increases. When stimulating this moment, it is necessary to take into account and increase the daily dose, but slightly, somewhere by 37.5 - 75 IU. Thus, in no case should the daily amount of Gonal administered exceed 225 IU, otherwise there may be a serious risk of hyperstimulation, which is fraught with the occurrence of cysts or even rupture of the ovary.

The average duration of ovulation stimulation with Gonal is 28-30 days. All this time, the processes occurring in the patient's ovaries are monitored by ultrasound. The first ultrasound is prescribed a few days after the first injection of the drug. Then you will need to visit the uzist's office every 2-3 days, so as not to miss the moment when the follicles reach the required size. On average, the dominant follicle before ovulation should increase to 20-25 mm.

If everything goes according to plan and the doctor sees all the necessary clinical and ultrasound signs of imminent ovulation, the woman will be prescribed an injection of human chorionic gonadotropin (hCG). The dosage is again strictly individual, in the range between 5000 and 10000 IU. This injection is needed to help the follicle rupture and release the egg. If you miss this moment and do not inject hCG, the follicle may begin to regress and turn into a cyst.

Ovulation occurs about a day and a half after the injection. This fact should be confirmed by another ultrasound examination. Now is the best time to conceive. With a good spermogram partner, problems should not arise. It is optimal if sexual intercourse occurs within 24-32 hours.

Immediately after ovulation, the doctor may prescribe a few more progesterone injections (the most popular drug is). Normally, this hormone should be produced by the corpus luteum - a gland that forms at the site of a burst follicle. But, in order to insure the ovaries and provide the egg with favorable conditions in the uterus, progesterone is also introduced from the outside.

Contraindications and possible side effects

Like any potent medicine, Gonal has some contraindications. So, additional infusions of follicle-stimulating hormone into the blood are prohibited when:

• the presence of large follicular cysts in the ovaries;
• sudden uterine bleeding of unknown etiology;
• malignant tumors in the uterus or ovaries;
• cancer and precancerous conditions of the mammary glands;
• brain tumors in the hypothalamic-pituitary region;
• obstruction of the fallopian tubes.

It is not for nothing that the need for a thorough preliminary examination has been emphasized so many times. If it turns out that there are obviously no primordial follicles in the woman’s ovaries (these are the “embryos” of future eggs that are formed in the woman’s body even when she is in the womb), then any stimulation is useless and even harmful.

Having decided on stimulation, you need to know that Gonal-F can cause individual intolerance. Most often, it is manifested by reactions of a general nature: headaches, nausea, heart palpitations, sharp jumps in blood pressure and body temperature. Allergic skin rashes are possible.

But, despite this, Gonal was and remains "heavy artillery", thanks to which many women managed to finally know the joy of motherhood. If the first stimulated ovulation is not successful, this is not a reason to despair. On the contrary, according to the observations of doctors, pregnancy most often occurs a few months after the course, which serves as a kind of "alarm clock" for the body and normalizes natural processes.

Content:

If a woman fails to get pregnant for a long time, then often this is not a final sentence. The way out is a comprehensive examination in order to find out and eliminate the causes of failure in the female body.

In case of problems with ovulation, doctors use various medical methods, namely drugs to stimulate ovulation.

All stimulant pills are designed to regulate ovulation and can have various effects: influence the formation of follicles, the maturation of the egg.

Who can and who does not need to be stimulated

Medicines to activate ovulation are prescribed: for women whose ovulation is characterized by irregularity, that is, it is absent or occurs quite rarely; women who cannot conceive naturally within a year; women over the age of 35 who have not become pregnant for more than six months. It is not recommended to stimulate ovulation if it is not possible to regularly monitor the formation of follicles using ultrasound, infertility has been detected in a man, and obstruction of the fallopian tubes has been stated in a woman.

Clomiphene to restore fertility

Clomifene is often prescribed to stimulate ovulation, especially in the case of detection of polycystic ovaries, the complete absence or irregularity of ovulation, before IVF, and the inability to identify the exact reasons that do not allow for a long time to conceive a child. The basis of the action of these pills is an increase in the production of hormones responsible for stimulating the functioning of the ovaries and releasing the egg. Due to the effect of Clomiphene on the female body, several formed eggs are prepared at the same time, which increases the couple's chances of having a child.

Treatment with the pharmaceutical preparation Clomiphene

It is necessary to start using Clomiphene on the third to fifth day after menstruation, and after the last pill, ovulation occurs on the fifth to ninth day. Therapy averages 5 days. It takes 1 or 2 cycles to restore regular ovulation, but in some severe cases it is necessary to undergo treatment that includes 3 to 6 cycles. Less commonly, doctors suggest extending treatment with this stimulant throughout the year at certain intervals, that is, going through 12 cycles. Sometimes doctors recommend taking an additional drug Metmorphine. These pills increase the ability of the female body to perceive Clomiphene and, accordingly, increase the chances of conception.

Women who suffer from polycystic ovaries need to be aware that treatment with Clomiphene may be useless due to the fact that some individuals with this diagnosis have resistance to this drug. Especially often problems occur in women with a body mass index above 25. It is recommended to first lose weight, and then continue treatment with Clomiphene. According to statistics, ovulation is restored in 70% of patients who take Clomiphene tablets. At the same time, a significant number of women (up to 50%) manage to become pregnant, and some (7%) even have twins.

Clostilbegit for conceiving a child

Clostilbegit is another pharmaceutical preparation, the purpose of which is to stimulate and, accordingly, conceive a child. Despite the fact that the active ingredient in this drug is clomiphene, Klostilbegit differs from the previous drug. The principle of action of this remedy is similar to Clomiphene. But, in addition to activating the production of pituitary hormones, it affects another hormone - prolactin, which is responsible for the presence of milk in the breast.

These tablets should be taken once a day from the fifth to the ninth day of the cycle. The starting point is the beginning of menstruation. If the attempt to get pregnant is not successful, then during the second cycle, the doctor may recommend an increase in the dose of the drug. It should be remembered that drinking this remedy is often impossible. The use of Clostilbegit more than 5 times throughout life is prohibited, which is associated with the negative effect of the substance on the functioning of the ovaries (the substance can cause their depletion). During the course of treatment with Klostilbegit, it is necessary to control the endometrium, because a thin endometrium can be the cause of pregnancy loss.

Puregon for anovulation

Another remedy that is prescribed for anovulation is Puregon. This pharmaceutical preparation in the form of injections can be recommended even for women diagnosed with polycystic ovaries, if other medicines have been powerless. Puregon affects the functioning of the pituitary gland, the formation of follicles by the ovaries, which increases the chances of ovulation occurring approximately in the middle of the cycle. Puregon can be used for both natural conception and IVF.

This drug should be administered subcutaneously or intramuscularly, and the first use of Puregon should be supervised by a physician, preferably with experience in the treatment of such disorders. As a rule, the first four days a large dose of the drug is administered, and the maintenance dose is determined individually. Usually Puregon therapy lasts until the formation of follicles, that is, 6-12 days. Less often, the course of therapy takes a longer time. In rare cases, the use of Puregon can provoke a rash, pain, swelling at the injection site, and sometimes allergic reactions.

Menogon for endometrial growth

For the treatment of anovulation in medicine, Menogon is also widely used, the principle of which is similar to previous drugs, but at the same time it has a positive effect on the growth of the endometrium, which differs significantly from Clostilbegit, for example. This remedy should be taken on the second day of menstruation. The number of doses depends on the reaction of the patient's ovaries and is prescribed individually. Basically it's 10 days.

A day after the use of various stimulant drugs (Menogon, Puregon), hCG injections (Pregnil, Gonacor, Horagon, etc.) should be given, which increase the chances of ovulation. Such injections are made once during the menstrual cycle. Within a day, ovulation occurs. That is why the day before the injection and after it, you should have sex so as not to miss the opportunity. In order to consolidate the long-awaited pregnancy, it is recommended to use progesterone pharmaceuticals. These include Duphaston.

Traditional medicine

In addition to the use of drugs for anovulation, women are sometimes recommended to take traditional medicine. Stimulating natural preparations include infusions of various herbs that you need to drink depending on the day of menstruation. During the first days of the menstrual cycle, you should take an infusion of sage 3 times a day, which has a beneficial effect on the formation of the egg, the development of the endometrium. Add 1 tablespoon of sage to a glass of boiling water. The upland uterus, which is rich in progesterone, must be taken from the second half of the cycle. Progesterone is responsible for maintaining early pregnancy. This tool can be combined with a red brush, which is widely used in gynecology.

There are other drugs that are responsible for stimulating ovulation: a decoction with a large amount of vitamin E, made from rose petals, aloe and quince juice. Do not forget about the vitamins necessary for the expectant mother: folic acid, potassium iodide and others. It must be taken into account that folk remedies may be more effective and beneficial, but their side effects are less studied. The choice must be made independently: either the experience of previous generations and folk doctors, or the results of modern research under the control of your doctor and ultrasound.

Possible unwanted effect

Medicines that stimulate ovulation can sometimes cause some side effects, including insomnia, irritability, sudden and frequent mood swings, depression, fatigue, nausea, vomiting, breast tenderness, abdominal pain, headaches , augmentation of the size of the ovaries, visual impairment, weight gain. But such temporary side effects for women are minor when they have a more important goal - to have a baby.

The drugs are prescribed to women depending on the results of ultrasound, various tests, as well as the age of the patient, the period of unsuccessful attempts to get pregnant, and possible causes of infertility. Take into account the fact that before using any pharmaceutical drug, the doctor must appoint you to undergo an examination to determine the patency of the fallopian tubes. Such measures will help protect the female body from ectopic pregnancy and, as a result, from unnecessary stress, which is so undesirable during pregnancy planning.

It should be remembered that the use of drugs that stimulate ovulation helps many women, even desperate ones, to feel the joy of motherhood. According to statistics, the first time a small number of patients (about 10%) get pregnant after the use of stimulant drugs, but still more than half of all cases (about 70%) end in the conception of a child. Just do not forget that your stimulation should always be under the total control of the doctor, only in this case you will save yourself from possible side effects.

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